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The future of breast cancer research

The Olivia Newton-John Cancer Wellness & Research Institute hosted its first Research Information evening, with three leading ONJ researchers outlining their work to members of the public. This informal discussion between researchers from the Cancer Research Institute, clinicians, patients and members of the public focused on the future of breast cancer research. According to Professor Robin Anderson, Head of the Translational Breast Cancer Program, the aim of the evening was to provide easier access to what happens ‘behind the glass walls’ of research. In the relaxed environment of the Wellness Centre, audience members heard from Dr Ashwini Chand, Dr Normand Pouliot and Dr Belinda Yeo.

The Olivia Newton John Cancer Research Institute Translational Breast Cancer Program

Dr Pouliot is Head of the Matrix Microenvironment and Metastasis Laboratory, a group that work within the Translational Breast Cancer Program. The Translational Breast Cancer Program is a newly-established research group within the ONJ Centre, headed by Professor Anderson, whose members include Dr Yeo. Its focus is on identifying the genes that control the spread of breast cancer, a process call metastasis. Using this knowledge, they are working on developing new and more effective treatments for patients whose breast cancer has spread, or metastasised.

Inflammation and breast cancer metastasis

The first speaker was Dr Ashwini Chand, a postdoctoral research fellow in the Cancer and Inflammation Laboratory. She spoke of the strategies used by the laboratory to identify new treatment targets for breast cancer.

The role of the Cancer and Inflammation Lab is to understand inflammatory cytokines, which are proteins produced by both cancer cells and immune cells. They play an important role in the immune system, but they can also surround tumour cells and encourage them to grow. The role of certain cytokines in breast cancer has not been of significant focus until now, but preliminary research suggests that they are, in fact, important in advanced breast cancers.

Dr Chand’s research has shown that making tumour cells unresponsive to certain cytokines has the potential to decrease tumour growth in breast cancers that are highly metastatic, meaning they spread easily to other parts of the body. Dr Chand’s hope is that this discovery can be used in combination with further therapies to eventually regulate tumour growth.

Dr Chand and her team have used this knowledge about these inflammatory mediators to take treatments that are already in clinics and harness a new use for them. This ‘retooling’ of existing drugs using a ‘new, previously undiscovered, pathway’ can result in the acceleration of a potential clinical trial and possible entry into the market.

Selective oestrogen receptor modulators are drugs that prevent oestrogen from encouraging the growth of cancer cells that are receptive to that hormone. Dr Chand and her team have demonstrated the effects of selective oestrogen receptor modulators, and commonly used anti-hypertensive medications, in reducing growth of tumours that are not receptive to oestrogen, but are receptive to certain cytokines. In this way, Dr Chand and her team are making discoveries that will contribute to more efficient emergence of breakthrough cancer treatments.

Estimating the risk of breast cancer recurrence

Dr Belinda Yeo is a clinician researcher, meaning she treats patients alongside carrying out breakthrough research. The focus of her talk, which we live-streamed on Facebook, was on estimating the risk of breast cancer recurrence. According to Dr Yeo, even for those very good prognosis cancers, up to one in six women are still at risk of breast cancer more than 10 years after their original diagnosis. Additionally, a large number of patients are prescribed ‘toxic treatments’ such as chemotherapy to prevent recurrence when potentially only few may benefit. It is clear, therefore, that developing a tool to more accurately predict the likelihood of a return of breast cancer has the potential to both save lives and spare some women who do not need ‘toxic treatment’.

Whilst there are currently a number of high-cost tools that can predict the risk of recurrence, Dr Yeo is passionate about developing a test that is not financially prohibitive. To that end, she and her colleagues have used a novel tool, called IHC4, an algorithm that takes into account a variety of tumour and patient factors and determines the risk of the cancer coming back over ten years. Dr Yeo reports that in her research of using this in clinic at the Royal Marsden, London, up to one in four women who would have otherwise been recommended chemotherapy were downstaged to lesser treatment.

Dr Yeo hopes to use IHC4 for patients over the next few years at the ONJ Centre. She envisages that with further research, this tool could one day be available to all relevant patients, possibly as an online calculator. This would allow wider access to a tool that makes use of existing technologies and information, rather than relying on costly tests. In this way, Dr Yeo is contributing to making new research available to more people, more quickly.

Dr Yeo also spoke about the exciting potential to investigate the use of the ‘liquid biopsy’ in patients with breast cancer. This is an area of research that analyses a person’s blood for signs of cancer. Liquid biopsies are possible because genetic information from cancerous cells is shed into the bloodstream, even if there are no metastatic tumours yet evident on standard imaging. Dr Yeo believes there is the potential to use liquid biopsies to detect recurrence earlier, however the clinical use of this technology requires significantly more reserach. She hopes that patients at the ONJ Centre can be part of future research into this exciting technology. Dr Yeo says: ‘These are very expensive studies to do, which require significant funding’.

Predicting and treating brain metastasis

The last speaker of the evening was Dr Normand Pouliot. Dr Pouliot, Head of the Matrix Microenvironment & Metastasis Laboratory, spoke about his research into whether it is possible to better predict and treat breast cancer that has spread to the brain.

Dr Pouliot outlined that up to thirty per cent of patients dying from breast cancer have brain metastasis, meaning the cancer has spread to the brain. Brain tumours are difficult to treat because the blood vessels in the brain have very few spaces through which drugs can fit in order to reach the cancer cells. Dr Pouliot identifies this as one of the major challenges in his field of work.

Dr Pouliot outlined two areas in which his laboratory is addressing this issue in order to effectively treat cancer in the brain. The first involves the use of HDAC inhibitors, which are drugs that were initially developed for use in psychiatry and neurology. The key property of HDAC inhibitors is that they are small enough to reach the brain and potentially treat the tumour or tumours.

Using pre-clinical models, Dr Pouliot and his team have shown a drop in the presence of visible brain metastasis from forty-five per cent to eight per cent in the case of an inhibitor called 1179.4b. Dr Pouliot acknowledges that ‘it’s certainly encouraging, but what we want is zero per cent’.

In addition to his work with HDAC inhibitors, Dr Pouliot’s laboratory has been investigating the use of a natural compound called [10]-Gingerol. Derived from ginger, it had previously been established that the compound could show some anti-cancer properties, but it had never been rigorously tested in relation to brain metastasis.

Dr Pouliot’s findings using [10]-Gingerol in pre-clinical models demonstrated an eighty-seven per cent decrease in visible metastasis; a promising start.

But the potential for [10]-Gingerol is also in its use in combination therapy. Dr Pouliot’s research has found that this compound can increase the sensitivity of tumour cells to radiation. This means that there is the potential for combining radiation therapy with [10]-Gingerol in order to treat patients with lower doses of radiation and achieve the same success.

Next month

Next month’s Research Information evening at the ONJ Centre will feature speakers on gastrointestinal and prostate cancers. Following on from the successful Facebook live streaming of Dr Belinda Yeo’s talk, we will once again be live streaming the presentations on the Olivia Newton-John Cancer Wellness & Research Centre Facebook page. Follow us on Facebook in order to be notified of when the next Research Information Evening is taking place and to be kept informed of future live streaming events.